广州地区无偿献血者戊型肝炎病毒感染流行病学调查

目的调查广州地区无偿献血者的戊型肝炎病毒(hepatitis E virus, HEV)感染情况。方法 2017年4月-2018年4月间收集了5 552名广州血液中心无偿献血者的血液样本,采用酶联免疫吸附法(enzyme linked immunosorbent assay, ELISA)检测抗-HEV IgG抗体(HEV IgG)、抗-HEV IgM抗体(HEV IgM)和HEV抗原(HEV Ag),采用χ~2检验分析年龄、性别、民族、职业和ALT等因素分别与HEV IgG和IgM抗体阳性的相关性,采用多因素Logistic回归分析判辨HEV感染的独立风险因素。结果 HEV IgG、IgM和HEV Ag的阳性率分别为20.05%(1 113/5 552)、0.76%(42/5 552)和0.04%(2/5 552)。年龄和民族是HEV IgG和HEV IgM阳性率的独立风险因素:HEV阳性率随着年龄增长而增大(IgG OR=1.089, 95%CI:1.080-1.098,P<0.001; IgM OR=1.055,95%CI:1.028-1.084,P<0.001);壮族的HEV IgG和IgM阳性率(32.69%, 7.69%)高于汉族(19.89%, 0.70%),差异有统计学意义(IgG OR=2.052, 95%CI:1.103-3.819,P=0.023; IgM OR=12.029, 95%CI:4.067-35.580,P<0.001)。此外,我们还发现职业是HEV IgG阳性率的独立风险因素,学生是阳性率最低的人群。结论广州地区无偿献血者中HEV抗体阳性率较高,且在不同人群中感染情况不同,为输血传播HEV的风险评估提供基础数据。

Epidemiological survey of hepatitis E virus infection in voluntary blood donors in Guangzhou

To investigate the prevalence of hepatitis E virus (HEV) infection among voluntary blood donors in Guangzhou. Blood samples from 5 552 blood donors were collected from April 2017 to April 2018 at the Guangzhou Blood Center and were tested for anti-HEV IgG antibody (HEV IgG), anti-HEV IgM antibody (HEV IgM) and HEV antigen (HEV Ag) by enzyme linked immunosorbent assay (ELISA). The association of age, gender, ethnicity, occupation and ALT with HEV IgG and IgM were analyzed by Chi-square test. Multivariate logistic regression analysis was applied to identify the independent risk factors of HEV infection. The positive rates of HEV IgG, IgM and HEV Ag were 20.05% (1 113/5 552), 0.76% (42/5 552) and 0.04% (2/5 552), respectively. Age and ethnicity were independent risk factors for HEV IgG and HEV IgM. The rate of HEV antibody increased significantly with age (IgG OR=1.089, 95%CI: 1.080-1.098, P<0.001; IgM OR=1.055, 95%CI: 1.028-1.084, P<0.001). Donors who were Zhuang minority (32.69%, 7.69%) showed higher anti-HEV than those who were Han ethnicity (19.89%, 0.70%), and the difference was statistically significant (IgG OR=2.052, 95%CI: 1.103-3.819, P=0.023; IgM OR=12.029, 95%CI: 4.067-35.580, P<0.001). In addition, we found that occupation was an independent risk factor for HEV infection, while students showed the lowest anti-HEV rate. The results indicate that the positive rate of HEV antibody among blood donors in Guangzhou is high, and the infection status differs in different populations. Our study provides basic data for the estimation of risk of transfusion-transmitted HEV.